Solitary Fibrous Tumor of the Orbit: A Clinicopathologic Entity that Warrants both a Heightened Awareness and an Atraumatic Surgical Removal Technique

Abstract

Purpose: To describe the first confirmed case of solitary fibrous tumor in Saudi Arabia and in the Middle East, and to illustrate a surgical technique for atraumatic complete removal. Methods: A retrospective interventional case report that describes the first confirmed case of solitary fibrous tumor in the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. Results: The clinical presentation, computed tomography (CT) findings, and histopathological, immunohistochemical and electron microscopic findings to confirm the diagnosis, as well as the cryodissection surgical technique for atraumatic removal of solitary fibrous tumor used, are described. Conclusions: Solitary fibrous tumor should be considered in the differential diagnosis when a patient presents with unilateral proptosis and a well-circumscribed, intensely enhancing mass on CT imaging. Because of the risk of malignant transformation, surgical en bloc removal with minimal tissue damage is the treatment of choice. This may be achieved by means of cryo-extraction via a minimally invasive orbitotomy.

KEYWORDS:

• Solitary fibrous tumor
• orbital tumor
• CD34
• spindle cell tumor
• proptosis
• cryodissection